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<br />'1113-780.0020
<br />
<br />City of Zephyrhills Permit Application
<br />Building Department
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<br />Fax-813-780-0021
<br />.~Co~.
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<br />Date Received
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<br />Owner Phone Number
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<br />I Owner Phone Number I
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<br />; , t4 ,~~lI..,"er Phone Number I
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<br />Owner's Address I .r- f( Lf3 . } a.... of I, 5 7
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<br />Fee Simple Titleholder ~amel S te-ff- L ......13'1 r b~ r'i A_
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<br />Owner's Name
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<br />WORK PROPOSED
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<br />B ADD/ALT D
<br />REPAIR
<br />o COMM D
<br />o FRAME D
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<br />P Itl VA. '-I.( Fv-. C:~
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<br />I3UILDING SIZE I . I SQ FOOTAGE 1 I
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<br />I ~ ' '. . , . . , . . . . , , . . , , , , . , . , . ., . . .. , , . . , , . , . . , j . , . , , . . , , ' . , . , , . . . . . . . , , . , , . , , . . , , , . , , . , , . . , . , . . , , . . , . , . . . , . , . . . . , I . , . . . . . , . . . . . . , , , , . . , . . . , . , . . , , . , , , I
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<br />Fee Simple Titleholder Address 'I ..5"F '-( 3 I ;;L f J,
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<br />LOTti
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<br />JOB ADDRESS
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<br />SUBDIVISION
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<br />PARCEL ID#I
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<br />IqBT AINED FROM PROPERTY TAX NOTICE)
<br />SIGN D MOVE D
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<br />~o Os,-O
<br />
<br />DESCRIPTION OF WORK
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<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
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<br />DEMOLISH
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<br />OTHER I "11..' ',/4,- V /-- e/I C:(
<br />STEEL D OTHER I
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<br />6 t li \ ~ I-, .
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<br />HEIGHT I
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<br />PROPOSED USE
<br />TYPE OF CONSTRUCTION
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<br />90
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<br />D BUILDING 1$ I
<br />D ELECTRICAL 1$ I
<br />0 PLUMBING 1$ I
<br />D MECHANICAL 1$ I
<br />D GAS D ROOFING 0
<br />FINISHED FLOOR ELEVATIONS
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<br />VALUATION OF TOTAL CONSTRUCTION
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<br />AMP SERVICE
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<br />o
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<br />PROGRESS ENERGY
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<br />D
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<br />W.R.E.C
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<br />VALUATION OF MECHANICAL INSTALLATION
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<br />
<br />BUILDER
<br />SIGNATURE
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<br />
<br />SPECIALTY D OTHER
<br />FLOOD ZONE AREA DYES DNO
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<br />COMPANY
<br />REGISTEREO
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<br />/-IO/J1e- CJ it; AI ~/2...
<br />I Y I N I FEE CURRENT
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<br />License # I
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<br />Y/N
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<br />Address
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<br />ELECTRICIAN
<br />SIGNATURE
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<br />COMPANY
<br />REGISTERED
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<br />Y/N FEE CURRENT
<br /> License #
<br />Y/N FEE CURRENT
<br /> License #
<br />Y/N FEE CURRENT
<br /> License #
<br />
<br />Y1N
<br />
<br />Address
<br />
<br />COMPANY
<br />REGISTERED
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<br />PLUMBER
<br />SIGNATURE
<br />
<br />Y/N
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<br />Address
<br />
<br />MECHANICAL
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />OTHER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />I YI N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address I License #
<br />11111111111111111111111111111111111111' 111111111111111I1111111111111111111I1111 i IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIJ 111111111111111
<br />RESIDENTIAL Attach (2) Plot Plans; (2) sl;lts of Building Plans; (1) set of Energy Forms .
<br />Minimum ten (10) working days after submittal date, Required onsite, ConstrUction Plans, Sanitary Facililles & 1 dumpster
<br />COMMERCIAL Attach (3) sets of Building Plans; (1) set of Energy Forms.
<br />Minimum ten (10) working days after submittal date. Required onsite, Construcllon Plans, Sanitary Facilities & 1 dumpster
<br />All commercial requirements must meet compliance.
<br />SIGN PERMIT Attach (2) sets of Engineered Plans.
<br />....PROPERTY SURVEY required for all NEW construction.
<br />11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111
<br />DIrections: . . .
<br />Fill out appllcallon completely,
<br />Owner & Contractor sign back of application. notarized
<br />If over $2500, a Notice of Commencement Is required. (AlC upgrades over $5000)
<br />.., Agent (for the contractor) or Power of Attomey (for the owner) would be someone with notarized letter from owner authorizing samfl
<br />
<br />OVER THE COUNTER PERMITTING (Front of Application Only)
<br />Reroofs Sewers Service Upgrades AlC Driveways
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